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Incremental threshold loading in patients with chronic obstructive pulmonary disease
L J Hopp1, M J Kim, J L Larson
1College of Nursing, Department of Medical-Surgical Nursing, University of Illinois at Chicago, USA.
Nursing Research
|July 1, 1996
Summary
This study found that while the absolute load tolerated in inspiratory muscle endurance tests varied, the relative load remained consistent in chronic obstructive pulmonary disease patients. This suggests the test is reproducible when accounting for individual inspiratory strength.
Area of Science:
- Pulmonary Medicine
- Respiratory Physiology
- Clinical Exercise Testing
Background:
- Chronic obstructive pulmonary disease (COPD) significantly impacts inspiratory muscle function and endurance.
- Assessing inspiratory muscle endurance is crucial for managing COPD patients.
- Incremental threshold loading is a potential method for evaluating inspiratory muscle endurance.
Purpose of the Study:
- To evaluate the reproducibility of the incremental threshold loading test for assessing inspiratory muscle endurance.
- To determine if chronic obstructive pulmonary disease severity affects test reproducibility.
- To analyze factors influencing test outcomes, such as absolute load, relative load, and breathing patterns.
Main Methods:
- Twenty-seven patients with mild to severe COPD participated in four weekly testing sessions.
- The incremental threshold loading test was administered to assess inspiratory muscle endurance.
- Measurements included maximum absolute load tolerated, load relative to inspiratory strength, and breathing patterns.
Main Results:
- A significant difference was observed in the maximum absolute load tolerated between the first and subsequent visits.
- No significant difference was found in the load relative to inspiratory strength across visits.
- Breathing patterns did not significantly change to explain absolute load variations, but rapid shallow breathing occurred near test completion.
Conclusions:
- The incremental threshold loading test demonstrates good reproducibility for inspiratory muscle endurance in COPD patients when normalized for individual inspiratory strength.
- Absolute load variations may reflect learning effects or other non-physiological factors on the initial visit.
- The test effectively identifies the limits of inspiratory muscle endurance in COPD patients, indicated by changes in breathing strategy at exhaustion.